Efficacy and safety of fenofibrate in combination with phototherapy for the treatment of neonatal hyperbilirubinemia: A systematic review and meta-analyses.

Author:

Abdellatif Mohammed1,Abozaid Ali Ahmed Fouad2,Shah Prakesh S3,Dhouibi Nacir4,Nguyen-Khac Thuan5,Khleif Rafeef6,Luu Mai Ngoc5,Quyen Dinh Kim5,Mohareb Anton7,Vaghela Gladson8,Khan Zeeshan Ali9,Pham Hoang Nhat10,Makram Abdelrahman M11,Huy Nguyen Tien12

Affiliation:

1. Starcare Hospital, 430304, Seeb, Muscat, Oman;

2. Ain Shams University, 68791, Cairo, Cairo, Egypt;

3. Mount Sinai Hospital and University of Toronto, Toronto, Canada;

4. University of Tunis El Manar, 37964, Tunis, Tunisia;

5. University of Medicine and Pharmacy Ho Chi Minh City Hospital, 377386, Ho Chi Minh City, Viet Nam;

6. Xavier University School of Medicine, 101684, Oranjestad, Aruba;

7. Aswan University, 435387, Sahary, Aswan, Egypt;

8. GMERS Medical College and Hospital, 379603, Gandhinagar, Gujarat, India;

9. Shadan Institute of Medical Sciences, 78401, Hyderabad, Telangana, India;

10. University of Milan, 9304, Milano, Italy;

11. Imperial College London, 4615, London, London, United Kingdom of Great Britain and Northern Ireland;

12. Nagasaki University School of Tropical Medicine and Global Health, 598388, Nagasaki, Japan;

Abstract

Phototherapy is the standard treatment for neonatal jaundice. We aimed to review the efficacy and safety of fenofibrate as an adjunct therapy. Twelve databases were searched and a systematic review and meta-analysis were conducted. Mean change (MC), mean difference (MD), and risk ratios (RR) with a 95% confidence interval (CI) were calculated using a random effects model. The GRADE approach was used to evaluate the evidence's certainty. Nine randomized trials were included. The MC of total serum bilirubin (mg/dl) (TSB) was significant at 12, 24, 36, 48 and 72 hours with respective MC (95% CI) values of -0.46 (-0.61, -0.310), -1.10 (-1.68, -0.52), -2.06 (-2.20, -1.91), -2.15 (-2.74, -1.56), and -1.13 (-1.71, -0.55). The FEN+PT group had a shorter duration of phototherapy (MD -14.36 hours; 95% CI -23.67, -5.06) and a shorter hospital stay (MD: -1.40 days; 95% CI: -2.14, -0.66). There was no significant difference in the risk of complications (RR: 0.89; 95% CI: 0.54, 1.46) or the need for exchange transfusion (RR: 0.58; 95% CI: 0.12, 2.81). The certainty of the evidence was very low for all outcomes. In conclusion, fenofibrate might be a safe adjunct to neonatal phototherapy. Larger RCTs are needed for confirmation of these results.

Publisher

Canadian Science Publishing

Subject

Physiology (medical),Pharmacology,General Medicine,Physiology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Progress in Treatment of Neonatal Jaundice;Advances in Clinical Medicine;2024

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